sermo.jpgSermo is a social-networking site for licensed physicians with the goal of making “good medicine great.” The site improves patient-outcomes by “physicians aggregating observations from their daily practice and then – rapidly and in large numbers – challenge or corroborate each others opinions, accelerating the emergence of trends and new insights on medications, devices and treatments.” Physicians post up case studies, seeking advice and opinions from other physicians on the diagnosis. Case studies are organized by open/close status and specialty area.

Upon registration, Sermo verifies that the registered user is a licensed physician in the United States. Those who are not licensed, will not be permitted to login. Sermo’s founder and CEO is Daniel Palestrant, MD who completed medical school from Duke University and trained in general surgery at Beth Israel-Deaconess Hospital, before leaving to start Sermo.

Their business model is to create a forum for physicians, and then aggregate that data in order to sell it to investment firms. However, members of the community have been discussing other topics besides clinical diagnosis, such as insurance reimbursement rates and the site has been an element in assisting the FDA to identify adverse events leading to recalls and advisories.

Sermo was well-received by the medical community until its recent announcement of the Pfizer deal. Many comments from the community has been negative, such as one physician lamenting: “Daniel, you let the enemy in. Shame on you.”

Comments from doctors around the web
From TheHealthCareBlog

  • “Sermo’s CEO needs to be careful of losing his audience in his zeal to monetize the site.”
  • “I don’t understand why many of my peers feel comfortable talking to one another in a venue that sells access to their comments to Wall Street and Big Pharma.”

Other coverage: WSJ, Financial Times, CNN

Analysis:
General Comments
Sustaining a Web 2.0 company with a revenue model is difficult. Dr. Palestrant is trying his best to strike a balance between medical ethics and establishing a revenue model. For instance, the AMA has determined that posts from Pfizer will be clearly marked to differentiate it from that of a physician’s and sponsored posts will not make up more than 2% of the postings. It’s a trial and error period for any startup. While I do hold the opinion that perhaps a non-profit or the AMA should be the ones to create such a service for physicians, the truth-of-the matter is that they never thought of it nor took the initiative. Dr. Palestrant saw a problem and tackled it. As with drug development or patient care, you’ll never reach a solution unless you try something.

As for Pfizer, they’re in for a surprise. I think that they are understimating how many physicians or other healthcare professionals are suspicious of drug companies with some even thinking that they are pure evil. This marketing move by Pfizer may backfire. As the AMA indicates, posts by Pfizer will be clearly marked. So what will this contribute to? in life, when you see “red”, you stop or you subconsciously think “alert”. Pfizer may have just made itself a red light.

Site Interface
Sermo should consider making physician postings in the form of a SOAP note. It’s more organized and helps physicians to write in a logical manner. SOAP notes would also assist physicians in providing a detailed description of the clinical case without missing vital medical points.

There is an option for physicians to search on drugs and gain insight into drug substitutions and adverse reactions. While this is a much needed area, it may be better if Sermo involve pharmacists, as pharmacotherapy is their specialty.

The Pfizer Deal
Sermo should have begun with simply asking Pfizer for sponsorship, meaning that a simple pharmaceutical logo placed on the site as a “sponsor” or allow Pfizer to sponsor CE programs.

By sponsoring CE classes, this allows Pfizer to have an image of improving patient care by advancing physician knowledge. It’s a delicate game played between drug companies and healthcare professionals. Having experience in both arenas, I’m surprised neither Sermo nor Pfizer came up with alternatives that would be well received by the medical community while being advantageous to both.

Room for another Health 2.0 company for healthcare professionals
There is room for a community specifically created for multi-disciplinary care where:

  • physicians may ask other physicians for diagnosis opinions
  • pharmacists asking other pharmacists for compounding inquiries
  • physicians asking clinical pharmacists for their pharmaceutical opinion on dosing, drug substitution, herbal use
  • licensed naturopathic doctors answering physician questions on holistic care implementation
  • nurses asking other nurses for strategies to improve daily patient care
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